Q&A

Birth Control Pills

Although most people assume that oral contraception was invented in the 1960s, the practice dates back thousands of years. Some ancient civilizations created drinkable potions of plants and tree bark. According to some reports, extract from the silphium plant was so effective in preventing pregnancy that the plant was used to extinction over fifteen hundred years ago![1]

In the Middle Ages new concoctions were invented, some of which proved to be fatal for the women, who didn’t realize the drawbacks of drinking mercury, lead, arsenic, and strychnine. Even when women did not ingest the medicine, they were often subjected to bizarre practices. Some civilizations urged women to wear amulets that contained the liver of a cat or the earwax of a mule![2] Over time, advances in medical technology replaced such superstitious and ineffective methods.

In the early 1900s, scientists began to experiment with the fertility of animals by using orally administered hormones. Some methods proved to be effective, but mass-producing enough hormones for human use seemed impractical. Scientists required gallons of urine or thousands of pounds of organs in order to extract a few milligrams of sex steroids.[3]

When a chemist in the 1940s was able to produce hormones from certain plants, researchers no longer needed the ovaries from more than two thousand pregnant pigs to create one milligram of progesterone. With only five gallons of liquefied roots of Mexican yams, he could create three kilograms of hormone. With continued progress in the development of synthetic hormones, oral contraception became a reality.

In 1950 Planned Parenthood invited an American biologist named Gregory Pincus to create an “ideal” and “harmless” form of birth control. As it usually does, research began on animals, such as rabbits and mice. Within a few short years, social workers in Puerto Rico were handing out oral tablets to women throughout the barrio. One witness recalls, “Women were told this was medicine that would keep them from having children they couldn’t support.”[4] What these women did not know was that they were being used as test subjects. During these clinical trials, three women died of complications that arose from taking the drug. As a result, the researchers changed the dosage and continued testing.[5]

Further studies were conducted in the United States and abroad, and the FDA approved the birth control pill for contraceptive use in 1960. It didn’t take long before safety concerns began to crop up, including the Pill’s tendency to increase a woman’s risk of suffering heart attacks and strokes. By 1970, the FDA initiated efforts to give information about the drug to the women who used it. As scientists learned more about the harmful chemicals in the Pill, they sought to experiment with different levels and types of hormones.

Over time the chemicals in the Pill have changed considerably. For example, when the Pill was first approved, it contained five times as much estrogen as some of today’s birth control pills.[6] Estrogen enhances clotting of the blood, and so the higher dosage of the hormone led to many injuries related to blood clots, such as strokes and heart attacks.

Because such levels of hormones were dangerous and unnecessary for women, the FDA told doctors in 1970 to prescribe the lowest possible dose of estrogen available at the time. Sales of the higher-dose pills began to drop. In 1973 those in the population control business saw the opportunity to obtain the high-dose pills at a low cost and spent millions of dollars buying up the leftover stock for shipment overseas for use by women in developing nations, despite the safety concerns.[7]

In order to prevent pregnancy, birth control pills employ several mechanisms. First, the synthetic hormones may convince a woman’s body that she is pregnant. This can stop the ovaries from releasing an egg. The Pill also makes it difficult for the sperm to reach the egg, because the hormones thicken the cervical mucus. Normally, on the days of each month when a woman is fertile, her cervical mucus has microscopic channels in it that make it easier for the sperm to travel to the egg. The mucus also nourishes the sperm, allowing them to live longer. However, when a woman is infertile (which is true for the greater part of each month) her cervical mucus changes. It looks more like a mesh or net at the microscopic level. The Pill causes the woman’s body to produce this type of cervical mucus on a continual basis, thus making it difficult for the sperm to live and move. The Pill also creates changes in the uterus and fallopian tubes that can interfere with the transport of sperm.[8] Despite the hormones’ ability to prevent the release of eggs, sometimes a “breakthrough ovulation” takes place. How often this happens depends upon several factors, such as which kind of pill the woman is taking, how consistently she takes her pills, and even how much she weighs. Even with correct and consistent use of the Pill, some formulas allow ovulation in less than 2 percent of cycles, while others allow a woman to ovulate during 65 percent of her cycles.[9]

When a woman ovulates, she can become pregnant. However, the Pill has mechanisms that can cause an abortion before a woman knows that she has conceived. Click here for a full explanation of how this works.

Sometimes, all of the Pill’s mechanisms fail to prevent pregnancy and successful implantation. It is often said that with optimum use of the Pill, it should have an effectiveness rate of 99 percent. Therefore, it is said to have a “method” failure rate of about 1 percent. However, in typical use the rates change significantly. This can be caused by many things, such as a woman’s forgetting to take her pill or taking it at the wrong time of the day. Thus the actual rate, called the “typical” or “user” failure rate. For the first year of use for women under the age of twenty, the Pill has an annual failure rate of 8 to 13 percent.[10] One study that followed sexually active teenage girls on the Pill found that 20 percent of them became pregnant within six months![11]

The typical failure rate of the Pill has been shown to vary according to such factors as a woman’s age, race, marital status, education, and economic status. For example, one large study showed that poor teenage girls who lived with their boyfriends had a 48 percent chance of getting pregnant during their first year on the Pill, whereas a wealthy married woman over the age of thirty had a 3 percent chance of pregnancy.[12]

There are numerous health risks in taking the Pill, since it contains potent synthetic hormones. According to the drug information that is included in birth control pills, the user may experience the following side effects: heart attack, blood clot, stroke, liver cancer, breast cancer, gallbladder disease, headache, bleeding irregularities, ectopic pregnancy, weight gain, mental depression, yeast infection, changes to the curvature of the eye, excessive hair growth in unusual places, loss of scalp hair, acne, partial or complete loss of vision, and more.[13] Some of these adverse reactions are rare, and others are more common, depending upon the type of pill and the particular woman who takes it.

The risk of breast cancer is especially worrisome for young women, since twenty-one of twenty-three studies of women who took the Pill prior to having their first child showed an increased risk of breast cancer.[14] The increase was especially steep among younger women. The World Health Organization and even the companies that sell birth control pills also admit that the drug can increase a woman’s risk of breast cancer.[15]

The birth control pill also has been shown to increase a woman’s level of SHBG (sex hormone binding globulin), which decreases the amount of testosterone available in her body.[16] This is one reason birth control pills are sometimes prescribed to treat acne. A decrease in free testosterone in a woman’s body may decrease the severity of acne. However, when testosterone is decreased, so is the woman’s sex drive.

It used to be thought that this undesirable side effect would be reversible. However, research published in The Journal of Sexual Medicine showed levels of SHBG twice as high as normal among women a year after they went off the Pill. The authors stated, “Long-term sexual, metabolic, and mental health consequences might result as a consequence of chronic SHBG elevation.”[17] In an article entitled “Can taking the pill dull a woman’s desire forever?” the same scientists feared, “There’s the possibility it is imprinting a woman for the rest of her life.”[18]

When women take the Pill for a long period of time, their risk of heart disease may be increased even after they go off the Pill. When this discovery was made, a cardiologist from Johns Hopkins University said, “What would I tell my daughter to do? I might suggest maybe not oral contraception.”[19]

Recent studies also suggest that if a woman becomes pregnant with a boy while taking the Pill, her son may be more likely to develop prostate cancer. This is because the synthetic hormones can deform the male prostate in developing baby boys. One researcher noted that the chemicals in the Pill are “extremely potent synthetic sex hormones, strong enough to completely control an adult woman’s reproductive system. . . . The developing fetus is extremely sensitive to chemical disturbance . . . so exposing a male baby to them is a very bad idea.”[20] Considering the failure rate of the pill and the number of women taking it worldwide, more than one million boys may be affected each year. Since this discovery is new, further research will need to be conducted in order to confirm and measure this risk.

Other studies suggest that the birth control pill can affect who you’re attracted to. Here’s what some scientists are saying: Many animal species have pheromones, which are odorless chemicals that can signal their availability, arousal, or sexual receptivity. This chemical can be detected by what’s called the vomeronasal organ (VMO), located in the nose. You may have heard that when women live together in close proximity, their menstrual cycles often begin to synchronize. Some have theorized that pheromones may play a role in this, because they can have an effect on hormones.

In animal studies, researchers have discovered that pheromones also play a role in mate selection. For example, a female mouse tends to choose a mate that has MHC genes that are least like her own. MHC (major histocompatibility complex) is a segment of our DNA that plays a role in the immune system, and it can be detected through pheromones in mice. By selecting a mate with the MHC genes most different from her own, the offspring of the mouse is given a greater variety of MHC molecules, thus strengthening its immune system and increasing its odds of survival. It’s one of nature’s ways of ensuring offspring with superior immune systems.

Because of these interesting findings, scientists have set out to determine if a similar mechanism is at work in human mate selection. Preliminary findings based on a woman’s preference of a man’s scent show that women also prefer mates who have MHC genes that are least similar to their own.[21] How does this all relate to the birth control pill? Women on the Pill have been shown to prefer the scent of men whose MHC genes are most similar to their own. So if a woman on the Pill mates with a man who has similar MHC genes, their offspring may have an inferior immune system. The explanation given for the change in the woman’s preferences is that the Pill causes a woman’s body to think that it is pregnant, and pregnant women tend to prefer the scents of family and relatives. Some women even reported that they felt less attracted to the men they were seeing after going off the Pill. Other researchers have proposed that because a woman’s fertility is interrupted when she is on the Pill, it alters her own pheromones. This, in turn, makes her less desirable to men, or so the theory goes.[22] While such research is interesting, it is still widely debated.

According to the Textbook of Contraceptive Practice, the Pill causes more than 150 biological changes in a woman.[23] Some of these changes are drastic, and others are hardly noticeable. For example, one study showed that women using oral contraceptives blink 32 percent more often than nonusers.[24] The reason for this may be that the chemicals in the Pill can decrease the hydration of the woman’s eye. The Pill also can cause a slight change in the shape of her eyeball, making the cornea steeper. These side effects could explain why women on the birth control pill often complain that their contact lenses have become uncomfortable.

Undoubtedly science has not fully grasped the many ways in which birth control pills interfere with a woman’s delicate and majestic physiology. Despite the possible side effects, birth control pills remain the most popular form of contraception for American women.[25] In turn, they have become a lucrative business. For example, one popular pill called Ortho Tri-Cyclen registered $715 million in sales in 2003.[26] Considering that it is only one of dozens of brands available, you can imagine the immense profits being made.